Leave Request Form - Sibley East Public Schools

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Leave Request Form, Non-certified Staff


Today's Date:	*

1. Name of Applicant	*

2. Leave Date(s) Requested	*

3. Site Location	*

4. Check Proper Leave	*

Name of Deceased (If funeral is selected)

Relationship to Employee (If funeral is selected)

5. From a.m./p.m. to a.m./p.m.	*

6. Workshop Information

7. Site of Workshop

8. Date and Time of Workshop:

9. Cost of Workshop: Registration Fees

10. Check Payable to:

Is Substitute Needed?

If "Yes", Please List Substitute

Send a copy of the completed form to this email address :

* Indicates Required fields.